CA 19-9

DESCRIPTION: CA 19-9 – Specimen Serum, plasma, pleural punctate, ascites Blood is collected in a vacuum tube (vacutube) with a red cap without additives or in a vacuum tube containing gel or in a vacuum tube (vacutube) with a green cap (Li-heparinate) or a purple cap (EDTA). The stability of the sample (serum, plasma) is 3 months at -20°C, 30 days at 4-8°C and 7 days at 15-25°C. 1979 a monoclonal antibody against human colorectal cancer cells is described for the first time. After that, an antigen with a molecular mass of 36 kD was isolated, which was called CA 19-9, or GICA (gastrointestinal cancer antigen). Chemical CA 19-9 is a monosialoganglioside (glycolipid) obtained from a mouse immunized with human colon cancer cells. It is elevated in 20-40% of patients with stomach cancer, 20-40% of patients with colon cancer and 70-93% of patients with pancreatic cancer. In people with pancreatic cancer, higher values may be associated with a more advanced stage of the disease. Benign conditions that can cause an increase in CA 19-9 are gallstones, inflammation of the pancreas, cirrhosis of the liver, and inflammation of the gallbladder. DETERMINATION: Recommended method of the Croatian Chamber of Medical Biochemists: Analyte/search: Carbohydrate antigen 19-9 (CA 19-9) Sample: Serum Measurement units: kIU/L The method of choice for determination is the immunometric method. RIA ELISA ECLIA CLINICAL SIGNIFICANCE: CA 19-9 is not a sufficiently specific and sensitive test to be recommended as a screening test for people who do not have symptoms of the disease. As many false-positive and false-negative results can be obtained, the search continues for one marker that would be specific and sensitive and with which the early stage of the disease could be detected (and could be used for screening). Normal laboratory values of this tumor marker in serum are up to 25 kIU/L. Its determination helps: in differentiating between cancer of the pancreas and bile ducts, and other non-cancerous diseases such as pancreatitis and for monitoring (monitoring) the success of the treatment of patients with pancreatic cancer as well as proving the possible return of the disease. CA 19-9 may be requested (determined) along with other tests such as CEA, bilirubin and/or “liver tests” when a patient has symptoms suggestive of pancreatic cancer including abdominal pain, nausea, weight loss and jaundice. Slightly elevated concentrations of CA 19-9 can also be found in a certain percentage of healthy people. Many diseases of the liver or pancreas can be the cause of increased values of CA 19-9. A significant increase in CA 19-9 levels is found in pancreatic cancer as well as in other serious diseases and conditions. The highest values were found in pancreatic duct cancer. About 25 percent of ovarian cancer patients also have elevated Ca 19-9 values. It is specific for the diagnosis of mucinous ovarian cancers and is often accompanied by CA.125 elevation in epithelial ovarian cancer. In benign diseases, the concentration of CA 19-9 is most often onic inflammation of the pancreas / Endometriosis, unspecified / Hepatocellular carcinoma; Liver cell carcinoma / Gallstones (cholelithiasis) / Renal cell carcinoma / Prostate carcinoma / Cholangitis / Colorectal carcinoma / Chronic hepatitis / Chronic hepatitis B / Chronic pancreatitis / Chronic viral hepatitis C / Malignant neoplasm of the testis, unspecified / / Malignant diseases / Malignant neoplasms of the intrahepatic bile ducts / Malignant neoplasms of the intrahepatic bile ducts; Cholangiocarcinoma / After liver transplantation / Gallbladder obstruction / Primary biliary cirrhosis / Primary liver cancer, hepatocellular carcinoma / Primary sclerosing cholangitis / Testis, unspecified (embryonic carcinoma) / Tuberculosis of the respiratory tract proven bacteriologically and histologically / Viral hepatitis / Malignant neoplasm of the colon (colon), carcinoma of the colon (colon) / Malignant neoplasm of the breast / Malignant neoplasm pancreas, pancreatic cancer, pancreatic cancer / Malignant neoplasm of the esophagus, carcinoma of the esophagus / Malignant neoplasm of the liver, (metastases) unspecified / Malignant neoplasm of the ovary (Ovarian cancer) / Malignant neoplasm of the lung, lung cancer nn) Malignant neoplasm of the testicle (testicle); M9102/3 Malignant trophoblastic teratoma / Malignant neoplasm of the body of the uterus (Endometrium) / Malignant neoplasm of the terminal colon (rectum), Rectal cancer / Malignant neoplasm of the stomach, gastric cancer, gastric cancer / Malignant neoplasm of the gallbladder B) Decreased values of CA 19-9 concentration in serum (plasma) in: RISIČNI FACTORS: Decreased values: Operative procedure Increased values: Liver transplantation DRUG EFFECT: Increased values: Biologically increased values: 17 ß estradiol Gliclazide RESULT: Reference range (depending on method, sex and age): Men and women SI units: less than 37 kIU/L (Conventional units: less than 37 U/ml) SI units: less than 40 kIU/L (less than 40 U/ml) Conversion factor (Conv – SI): U/ml x 1 = kIU/L Conversion factor (SI – Conv): kIU/L x 1 = U/ml 1 U = 0.8 ng glycoprotein